초록 열기/닫기 버튼
Purpose: The aim of the current study was to evaluate the adverse clinical impact of intraoperative conversion during laparoscopicpancreaticoduodenectomy (LPD). Materials and Methods: The medical records of patients who underwent pancreaticoduodenectomy (PD) were retrospectivelyreviewed. Perioperative clinical variables were compared between patients who underwent converted PD (cPD) and initiallyplanned open PD (OPD) to investigate the clinical impact and predictive factors of intraoperative conversion during LPD. Results: A total of 171 patients were included. Among them, 31 patients (19.3%) were found to have intraoperative conversion duringLPD. Failure of progression due to severe adhesion (12 patients, 7%) and major vessel invasion (7 patients, 4%) were the twomost frequent reasons for conversion. On multivariate analysis, age [Exp(β)=1.044, p=0.044] and pancreatic texture [Expa(β)=2.431,p=0.039) were found to be independent factors for predicting intraoperative conversion during LPD. In comparative analysis withthe OPD group, the cPD group had a longer operation time (516.8 min vs. 449.9 min, p=0.001), higher rate of postoperative hemorrhage(12.1% vs. 0.85%, p=0.008), higher reoperation rate (9.1% vs. 0%, p=0.01), and higher cost (21886.4 USD vs. 17168.9 USD,p=0.018). Conclusion: Intraoperative conversion during LPD can have an adverse clinical impact on the postoperative course followingLPD. Appropriate patients selection and improvement of surgical techniques will be crucial for unnecessary intraoperative conversionand safe LPD.
